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Organization

MARSHMALLOWS HOPE NONPROFIT ORGANIZATION

Active
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Organization

MARSHMALLOWS HOPE NONPROFIT ORGANIZATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LESLIE ELMER CPCS (CREDENTIALING MANAGER)
(608) 352-8323
Entity
Organization

Contact information

Practice address
319 E MADISON ST STE 4N, SPRINGFIELD, IL 62701-3133
(888) 277-4028
Mailing address
319 E MADISON ST STE 4N, SPRINGFIELD, IL 62701-3133

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary

Other

Enumeration date
04/02/2026
Last updated
08/18/2026
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